SAMPLE: Debt payment agreement letter
Today’s Date
Your name
Your address
Attention: (Name of Collector)
Name of Collection Agency
Address of Collection Agency
RE: Your [letter dated] or [phone call on date]
Reference account # (account # here)
Dear Mr./Ms. (Collector’s last name):
According to your correspondence and my own records, the amount of debt owed is $(___). This
letter is not to dispute this debt but to inform you that my present financial situation prohibits me
from paying the amount you are asking.
Per our last contact on (date) by (phone or letter) we came to an agreement as to what my
payments will be on this account. I will be making payments on this account every (date of
month) to your company in the amount of $(___).
Enclosed is my first payment in the amount of $(___). I will consider your cashing or depositing
my payment as confirmation that you accept the payment terms we have discussed.
Thank you.
Sincerely,
Sign your name
Print your name